Active NPI
John Brady Culbertson, DDS
- Dentist
- Broken Arrow, OK
National Provider Identifier
1649963802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7734
- Practice address
- 427 Stone Wood Dr
Broken Arrow, OK 74012-1026 - Phone
- (918) 615-3580
- NPI assigned
- Jun 1, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7734 | OK | Primary |
Addresses
Primary practice location
427 Stone Wood Dr
Broken Arrow, OK 74012-1026
Mailing address
4051 S 211TH East Ave
Broken Arrow, OK 74014-8717
Phone (469) 261-5501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7734 | OK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1649963802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4051 S 211TH EAST AVE",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740148717",
"telephone_number": "469-261-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 STONE WOOD DR",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740121026",
"telephone_number": "918-615-3580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULBERTSON",
"first_name": "JOHN",
"middle_name": "BRADY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-01",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "7734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.